TINA LYNN POLACH Registered Nurse License verification

Business Entity

INACTIVE

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043088954

License Status

INACTIVE

Business

First Name

TINA

Middle

LYNN

Last Name

POLACH

Business Name

TINA LYNN POLACH

Original Issue Date

09/29/2003

Effective Date

01/20/2005

Expiration Date

01/31/2005

City

BUNKER HILL

State

Zip

62014

County

MACOUPIN

Ever Disciplined

LastModifiedDate

10/21/2005